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ICD Code: 493. Asthma



ICD Code: 493. Article Review
Title: American Lung Association; "Trends in Asthma Morbidity and Mortality." http://www.lungusa.org/atf/cf/{7A8D42C2-FCCA-4604-8ADE-7F5DE762256}/ASTHMA1.pdf; Accessed 7/31/04; p1
      LIFETIME PREVALENCE: Based on the 2002 National Health Interview Survey sample, it was estimated that 30.8 million Americans, or 110.6 per 1000 persons, had been diagnosed with asthma by a health professional within their lifetime. Between 1997 and 2002, children 5 to 17 years of age have had the highest prevalence rates. In 2002, 140 per 1000 children ages 5 to 17 had been diagnosed with asthma in their lifetime.
      The number of people who were ever told by a health professional that they had asthma (lifetime prevalence) for 2000, 2001, and 2002, respectively, was reported as follows (with the prevalence rate per 1000 persons in parentheses): all ages, 27,615,006 (100.8), 31,353,657 (113.4), 30,821,125 (110.6); younger than five years, 1,535,639 (78.3), 1,552,713 (78.7), 1,451,929 (73.2); 5 to 17 years, 7,382,614 (140.0), 7,631,820 (144.2), 7,442,217 (140.0); all persons younger than 18 years, 8,918,253 (123.3), 9,184,533 (126.4), 8,894,146 (121.9); 18 to 44 years, 10,676,318 (98.4), 12,795,275 (118.0), 12,453,741 (115.2); 45 to 64 years, 5,266,650 (87.0), 6,507,867 (104.1), 6,836,046 (105.7); 65 years and older, 2,753,785 (84.2), 2,865,982 (87.2), 2,637,162 (79.8); all persons older than 18 years, 18,696,753 (92.7), 22,169,124 (108.8), 21,926,949 (106.5).
      Females have had consistently higher asthma rates than males. In 2002, females were about 10% more likely than males to ever have been diagnosed with asthma. The difference between sexes was not statistically significant.
      Blacks are more likely to be diagnosed with asthma over their lifetime. In 2002, the prevalence rate in blacks was 29% higher than the rate in whites. Since 1997 the differences in lifetime asthma prevalence between races have been statistically significant.
      CURRENT PREVALENCE: Over 20 million Americans (6.1 million children) had asthma in 2002: a rate of 71.8 per 1000 population. The highest prevalence rate was seen in those 5 to 17 years of age (91.9 per 1000 population), with rates decreasing with age. Overall, the rate in those under 18 (83.1 per 1000) was significantly greater than those over 18 (67.8 per 1000).
      In 2002, 8.5 million males and 11.6 million females had asthma. The prevalence rate in females (81 per 1000 persons) was almost 30% greater than the rate in males (62.6 per 1000 persons). However, this pattern was reversed among children. The current asthma prevalence rate for boys aged 0 to 17 years (94.8 per 1000) was over 30% higher than the rate among girls (71.6 per 1000). The difference in rates between sexes was statistically significant in both children and adults.
      In 2002, the current asthma prevalence rate was 38% higher in blacks than in whites. This difference between races was significant. The highest prevalence rates for whites and blacks were among the 5 to 17 age group. Whites had the lowest prevalence rates in those under 5 and blacks had the lowest in those over 65. Over the past year, the asthma prevalence rate in blacks has increased 8.5%, while decreasing 3.5% in whites.
      ATTACK PREVALENCE: The proportion of attacks that occur within a population at a single point in time is the attack prevalence. In this report, it is the proportion of people who had one or more asthma attacks or episodes in the preceding year. This type of period prevalence estimate measures for active asthma. In 2002, an estimated 11.9 million Americans (4.2 million children under 18) had an asthma attack. This represents 60% of the 20 million people who currently had asthma. The asthma attack rate was 42.7 per 1000 population in 2002.
      MORTALITY: The number of asthma deaths for the years 1999, 2000, and 2001, respectively, was reported as follows (males versus females in parentheses): all deaths, 4657 (1620 vs 3037), 4487 (1632 vs 2855), 4269 (1479 vs 2790); whites, 3328 (1046 vs 2282), 3144 (1057 vs 2087), 2990 (937 vs 2053); all races other than whites, 1329 (574 vs 755), 1343 (575 vs 768), 1279 (542 vs 737); blacks, 1145 (481 vs 664), 1158 (481 vs 677), 1108 (459 vs 649).
      The age-adjusted death rate per 100,000 population for the years 1999, 2000, and 2001, respectively, was reported as follows (males versus females in parentheses): all deaths, 1.7 (1.4 vs 2.0), 1.6 (1.3 vs 1.8), 1.5 (1.2 vs 1.7); whites and, 1.4 (1.0 vs 1.7), 1.3 (1.0 vs 1.5), 1.2 (0.9 vs 1.5); all races other than white, 3.4 (3.3 vs 3.5), 3.3 (3.1 vs 3.5), 3.0 (2.8 vs 3.2); blacks, 3.9 (3.6 vs 4.2), 3.9 (3.5 vs 4.2), 3.6 (3.2 vs 3.8).
      The age-specific asthma mortality rate per 100,000 population for 1999, 2000, and 2001, respectively, was reported as follows: total, 1.7, 1.6, 1.5; 1 to 4 years, 0.2, 0.2, 0.2; 5 to 14 years, 0.3, 0.3, 0.2; 15 to 24 years, 0.5, 0.4, 0.4; 25 to 34 years, 0.7, 0.7, 0.6; 35 to 44 years, 1.0, 1.0, 1.0; 45 to 54 years, 1.7, 1.7, 1.5; 55 to 64 years, 2.5, 2.3, 2.2; 65 to 74 years, 4.2, 4.0, 3.5; 75 to 84 years, 7.6, 6.9, 6.4; 85 years and older, 17.2, 16.5, 16.1.
      DISCUSSION: Due to decennial revisions of the International Classification of Diseases coding system and the change in age-adjusted standard population, the number and rate of asthma deaths for 1999-2001 are not directly comparable to those reported for 1979-1998.
     

Search Criteria: Text - American Lung Association; "Trends in Asthma Morbidity and Mortality." http://www.lungusa.org/atf/cf/{7A8D42C2-FCCA-4604-8ADE-7F5DE762256}/ASTHMA1.pdf; Accessed 7/31/04; p1